Haywood jail inmates rack up big medical bills

A rash of medical complications hit inmates in the Haywood County jail over the past year, socking the county with a $100,000 cost overrun.

Blame lies in part with a handful of big ticket procedures — a major stroke, heart bypass surgery, a heart catheterization following a heart attack for another. But there was also a run on more minor hospitalizations.

“For the first nine months this year we had 60 people admitted to the hospital that were inmates,” said Haywood County Sheriff Greg Christopher.

Haywood’s jail had a streak of bad luck, but medical costs for inmates have been trending upwards year after year.

“We only seem to bring in people who are very, very unhealthy. There’s very few marathon runners or people who are in good shape when they come to the jail,” said Christopher.

The jail population has its share of drug addicts, alcoholics and smokers. They are more likely to have bad teeth and poor nutrition. And these hallmarks of an unhealthy lifestyle add up to more medical issues.

Christopher can’t help but wonder.

“Some people might commit a crime to go to jail just so we’ll be there to fix the problem,” the sheriff said.

Shuttling inmates to the hospital or specialists has also been a drain on the budget. And while in the hospital, inmates have to be babysat 24/7 by a deputy.

“We have to sit there the whole time they’re in the hospital,” Christopher said.

During a concatenation of inmate medical problems this past year, Christopher had five deputies at the hospital with five different inmates. This contributed to a $56,000 cost overrun for overtime for deputies.

Haywood County isn’t the only one seeing rising costs in jails. The budget Macon County Manager Derek Roland recommended for 2014-15 includes a $100,000 increase in the medical treatment line item for inmates, doubling the previous budgeted amount of $100,000 to $200,000. That increase has led the county to find an insurance policy they will be able to purchase for the inmates.

Rising jail costs in Macon also include $50,000 more for jail food service in the 2014-15 recommended budget. Since the last fiscal year, meal costs have increased by 35 cents per day, Roland said, and the average length of stay has risen as well.

“Those are things that at this point are out of our control,” Roland told commissioners at their May 13 meeting.

Jackson County’s burden isn’t quite so severe. During the current fiscal year, the county has spent $27,319.97 for inmate medical services. Another $11,581.92 was spent for medications, bringing the county’s total cost for inmate health care to $38,901.89. The county’s proposed budget for next fiscal year stays the course with $45,000 for inmate health care.

Two years ago, Haywood County outsourced with a private firm that specializes in overseeing health care in county jails, a common trend nationwide. The county hoped it would save money with a fixed-rate contract.

But it wasn’t all-inclusive. The county still bore the liability of hospitalizations and treatment by specialists. And the rash of major medical issues with inmates squelched hopes of cost savings under the outside provider.

Haywood’s cost overrun of $100,000 this fiscal year seems more dramatic in part due to optimistic budget projections on the front end.

Almost every year, the county budgets for inmate medical care with its fingers crossed. But by year’s end, the projections prove too optimistic and more money has to be allocated.

• In 2012-2013, $240,000 was spent on inmate medical costs.

• In 2013-2014, $267,000 is the likely tab for inmate medical costs.

• In 2014-2015, $184,000 has been budgeted for inmate medical costs.

Inmates treated to universal health care on county taxpayer dime

Counties are on the hook for medical costs for inmates parked in the county jail awaiting trial. Once they go to court, if found guilty, they enter the state prison system and become the state’s problem.

But as long as they are sitting in the county’s jail — whether it’s just a few days while scrapping together bail or many months while awaiting trial on serious charges — the county is legally responsible for all their medical costs, including dental work, prescription drugs, x-rays, specialist visits, hospitalizations and nurse and doctor evaluations.